Analysis of Potential Bone Donors and Deferral Rates for Bone Bank in a Tertiary Care Hospital
Abstract
Background: Bone grafts are widely used in various orthopaedic procedures. Problems of limited availability of autograft and donor site complications can be overcome by use of allograft procured from the bone bank. The banks are underutilized due to high donor deferral rate. Hence this study is done to analyse the donor profile and donor deferral rate of our bone bank.
Material & Methods: Donor deferral rate in pre-harvesting phase, intraoperative phase and post harvesting phase in 67 patients of fracture neck of femur undergoing hemi-replacement / total hip replacement (THR), osteoarthritis hip undergoing THR and osteoarthritis knee undergoing total knee replacement, who donated the bone was analysed.
Results: Overall donor deferral rate was 69% as 46 donors out of the total 67 were rejected and only 21 (31%) donors were eligible for use. 24 (35%) donors were rejected during the pre-harvesting stage; 1 (1.4%) donor was rejected intraoperatively, whereas 21 (31 %) donors were rejected during the post harvesting period.
Conclusion: High rate of donor deferral rate has led to donation losses and burden on limited resources. Awareness, effective trained staff, proper counselling and consent, improved serological testing and equipped bone banks can reduce donor rejection and meet the increasing demand for bone grafts.
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References
Roberts TT, Rosenbaum AJ. Bone grafts, bone substitutes and orthobiologics: the bridge between basic science and clinical advancements in fracture healing. Organogenesis. 2012;8(4):114–24.
Baldwin P, Li DJ, Auston DA, Mir HS, Yoon RS, Koval KJ. Autograft, allograft, and bone graft substitutes: clinical evidence and indications for use in the setting of orthopaedic trauma surgery. J Orthop Trauma. 2019;33(4):203-13.
Younger EM, Chapman MW. Morbidity at bone graft donor sites. J Orthop Trauma. 1989;3(3):192-5.
Burchardt H. Biology of bone transplantation. Orthop Clin North Am. 1987;18:187-96.
Bos GD, Goldberg VM, Zika JM, Heiple KG, Powell AE. Immune responses of rats to frozen bone allografts. J Bone Joint Surg Am. 1983;65(2):239-46.
De Alencar PG, Vieira IF. Bone Banks. Rev Bras Ortop. 2015;45(6):524-8.
Zwitser E, Royen BV. Quality Control in Hospital Bone Banking In: Akyar I editor. Wide Spectra of Quality Control. 1st edi. InTech. 2011. pp251-66.
Zwitser EW, Jiya TU, George Licher H, van Royen BJ. Design and management of an orthopaedic bone bank in The Netherlands. Cell Tissue Bank. 2012;13(1):63-9.
Nather A. Organisation, operational aspects and clinical experience of National University of Singapore Bone Bank. Ann Acad Med Singapore. 1991;20(4):453-7.
O`Sullivan JP. Bone Banking: from Tamworth Base Hospital to Royal Newcastle hospital. Aust NZ J Surg 1993;63:124-6.
Khan SN, Cammisa FP Jr, Sandhu HS, Diwan AD, Girardi FP, Lane JM. The biology of bone grafting. J Am Acad Orthop Surg 2005;13:77-86.
Shimandle JH, Boden SD. Bone substitutes for lumbar fusion: present and future. Oper Tech Orthop 1997;7(1):60-7.
Giannoudis PV, Dinopoulos H, Tsiridis E. Bone substitutes: an update. Injury 2005;36 (Suppl 3):S20-7.
James JI. Tuberculosis transmitted by banked bone. J Bone Joint Surg Br. 1953;35-B(4):578.
World Health Organization. Global tuberculosis report 2018. Geneva, Switzerland: World health organization. 2018. (https://www.who.int/tb/global-report-2019)
Palmer SH, Gibbons CL, Athanasou NA. The pathology of bone allograft. J Bone Joint Surg Br. 1999;81(2):333-5.
Tomford WW. Transmission of disease through transplantation of musculoskeletal allografts. J Bone Joint Surg Am 1995;77(11):1742-54.
Buck BE, Malinin TI, Brown MD. Bone transplantation and Human immunodeficiency virus. An estimate of risk of acquired immunodeficiency syndrome (AIDS). Clin Orthop Relat Res 1989;240:129-36.
Conrad EU, Gretch DR, Obermeyer KR, et al. Transmission of hepatitis-C virus by tissue transplantation. J Bone Joint Surg Am 1995;77(2);214-24.
Ison MG, Nalesnik MA. An update on donor-derived disease transmission in organ transplantation. Am J Transplant. 2011;11:1123–30.
Vehmeyer S, Wolkenfelt J, Deijkers R, Petit P, Brand R, Bloem R. Bacterial contamination in postmortem bone donors. Acta Orthop Scand. 2002;73(6):678-83.
Sims L, Kulyk P, Woo A. Intraoperative culture positive allograft bone and subsequent postoperative infections: a retrospective review. Can J Surg 2017;60(2):94-100.
James LA, Ibrahim T, Esler CN. Microbiological culture results for the femoral head. Are they important to the donor? J Bone Joint Surg Br 2004;86:797–800.
Lorenz R. Air Conditioning System. Acta Neurochir (Wien) 1980;55:49-61.
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